To consider information on the management of the local care market.
Professor Sarah Scott, Executive Director of Adult Social Care and Public Health, introduced the report and gave an overview of information relating to the challenges of managing adult social care in Gloucestershire.
It was explained that the Care Act 2014 sets out the law around market development in adult social care. Under the Act, Gloucestershire County Council, (GCC), has a duty to not only meet and fund the needs of people eligible for care, but also to shape the local care market to encourage quality, choice and sufficiency of provision. This duty applies to the whole local population, including those who pay for their own care. Equally, it extends beyond care which is commissioned, and includes the informal care and support provided by families, networks of support and in communities.
In addition to the statutory requirement under the Care Act to manage care markets, GCC also has duties to improve the quality of care under the Health & Social Care Act 2012. It was explained that the key focus of achieving this is to ensure care is integrated around the needs of patients/people. It was reported that, in the past, the handover of responsibility between the NHS and social care had often been problematic. The Care Act aimed to ensure greater integration between services, including community based commissioned services from the independent and voluntary sectors. Market management includes services that support both health and social care delivery, whether purchased by public authorities or by private individuals.
As well as the statutory duties outlined in the Care Act, the County Council also has responsibilities under the Transforming Care Programme and the Gloucestershire Transforming Care Partnership. Transforming Care aims to improve health and care services for people with learning disabilities and/or autism, by allowing them to live, with support, closer to home.
The report set out a brief assessment of the current care market, the challenges and changes faced by the County Council and its response to such pressures.
The report confirmed that the County Council was committed to working with the care market to provide high quality, affordable care and support and promote independence. To deliver these aims, the council recognised:-
Ø The need to increase the availability and range of care and support delivered in people’s own homes and communities;
Ø The need for more specialist care from which to support people with complex needs across all settings, including the predicted rising demand for nursing care;
Ø The need for fewer long-term residential placements, from which it was anticipated that the shrinking market was likely to result in the closure of some establishments;
Ø The importance of increasing the availability and responsiveness of home care and short-term care provision to support hospital discharge and achieve better long-term outcomes for people.
It was confirmed that the council aimed to share intelligence about shifting choices and the demands across the Integrated Care System. The council to work collaboratively with the market to support and grow a skilled and sustainable workforce which will ensure access to quality care. Emphasising the need to ensure that the county’s care offer remained sustainable within the current financial context, the council aimed to continue to invest in supporting the development and sustainability of the care market.
Noting the impact of demographic changes on the demand for care and the impact of the Covid-19 pandemic, it was confirmed that such consequences had had a profound effect on the care market, including increasing demands on the domiciliary care market. Although too soon to assess the full impact of the pandemic, it was noted that the next few years would require careful and strategic management of the care market. The need to consider demand and supply factors and to address the ongoing issue of recruitment would be essential.
Responding to questions on how to address the challenges presented to the Gloucestershire care market, it was suggested that the committee continue to receive regular updates on the ‘Adult Single Programme’, including updates on the use of the three tier model, as part of the regular reporting to the committee. Acknowledging the need to respond to the government announcement anticipated later that day, it was agreed the issue would need to be brought back to future meetings.
The report was noted.